Substance abuse is a significant problem for women with severe physical and psychological consequences. Women experiencing a faster progression of alcoholism with less consumption of alcohol than do men. This increased rate of progression contributes to more alcohol-related illnesses in a shorter time period. Substance abuse in women is often present with other comorbid psychiatric disorders making diagnosis and treatment more difficult. Few studies have examined risk factors for substance abuse among low income, rural women. The aim of this cross- sectional, descriptive study is to compare a group of rural substance abusing women (SA) with a group of rural non-substance abusing women (NSA) on risk factors for substance abuse identified by previous epidemiological and clinical studies. Within the SA group, women with and without a comorbid DSM-IV disorder also will be compared on the same risk factors. Those risk factors include sociodemographic risk factors, family history, victimization, daily hassles and uplifts, alcohol expectations, coping, and self-esteem. The sample will include 180 low income, rural women from two types of agencies: (8) substance abuse treatment centers and (6) public health clinics serving the same rural counties. Women will be assigned to the substance abusing or the non-substance abusing group based on results of the National Institute of Mental Health (NIMH) Diagnostic Interview Schedule (DIS) using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Results of the diagnostic interview also will be used to establish dual diagnoses. Several sampling strategies will be used. For the SA group, the following strategies will be used: (1) Participating treatment centers will explain the study to clients currently in treatment and ask for volunteers; (2) Treatment centers will mail recruitment letters to clients who have been treated in the past two years; (3) A snow-ball technique will be used to identify additional substance abusing women; and (4) Fliers describing the study and asking for volunteers will be posted in buildings that host Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) meetings in rural areas. For the NSA group of women, the following strategies will be used: (1) Women will be actively recruited from DHEC clinics serving women and children; (2) The PI will work with women who are leaders in rural churches to recruit women; and (3) A snow-ball technique will be used to identify additional women. Equal numbers of African-American and Caucasian women will be recruited into the SA and NSA groups. Descriptive statistics will be used to describe sample characteristics and scores on all measures of interest. Crosstab (Chi Square) procedures will be used to examine group differences among categorical variables, and MANOVA will be used to examine group differences among continuous variables of interest. This study will make a significant contribution to our knowledge of substance abuse among rural women. That knowledge is essential prior to designing cost- effective treatment programs to address the unique needs of this vulnerable population.